I am 67 and am on Medicare with Aetna as secondary insurance. I had been on Provigil for at least 10 years up until I turned 65 when I could not afford the cost ($575 monthly due to Medicare) to continue the medication. My doctor has given me the 30-day-trial form to fill out for Nuvigil; however, neither Medicare nor Aetna (secondary Part D) would even accept the trial request --because I am 67. Provigil was the first medication that really worked. I was dignosed with Narcolepsy when I was 15 so I have lived with this disorder for 52 years. Giving up Provigil due to the high cost of this medication was a very sad decision, as all the symptoms have come back. Is there any recourse for my situation?
What options are recommended when insurance & Medicare refuse to pay for Nuvigil and/or Provigil?
- Posted:
- 26 Aug 2010 by 123waters
- Topics:
- nuvigil, provigil, narcolepsy, attention deficit hyperactivity disorder (adhd), drowsiness, obstructive sleep apnea/hypopnea syndrome, chronic fatigue syndrome (cfs)
Details:
Answers (3)
jk1326 Aug 2010
I'm so sorry to hear all of this!! That's just awful! Nuvigil and Provigil are kinda one of a kind drug, and there is no real comparison. The only other stimulant options that would be appropriate would be the other more severe stimulants such as Adderall and Ritalin. You could also try, if insurance covers it, Xyrem (I've heard that it can cost up to $800, but I may be wrong on this) - a hypnotic drug that is or is very similar to a benzodiazepine. Apparently, when taken at night, it regulates your sleep and somehow eliminates the Narcolepsy. For me, I get regular sleep attacks durring the daytime, get sleepy and week when stressed, and am on 250mg of Nuvigil. It keeps me awake durring the daytime, however, I still can't stay awake past 8:00pm. I have anxiety issues among others, and am unable to simply stop taking my medications. In order for you to be tested for Narcolepsy, you have to take a daytime sleep study, drug free. So...
27 Aug 2010
The company that makes Provigil and Nuvigil is called Cephalon. That company has a patient assistance program called the Cephalon Cares Foundation. You can contact them at www.cephalon-us.com or at Cephalon Cares Foundation P.O. Box 66585 St. Louis, MO 63166-6585. Oh yeah, here is a phone number as well: 1 (800) 707-8990. Hope this helps.
LaurafromTx
11 Mar 2012
I believe that you have to be uninsured to get any help from the makers of nuvigil. If have have any insurance AT ALL they will not help you, but call them and make sure. This is just from what I read on their website.
ruthrwd
28 Apr 2012
The program does not help if you have Medicare or part d drug plan but ask plans change . They did explain that other part d programs have coverage .I found in NJ that aarp part d was approved where atna was not .Then padd picked cost balance aarp part d did not and brought down 30 day supply to max of 14 dollars. It seams each state has different approved plans lits of aproved drugs ,lots of paper work but worth it .Walgreen's pharmacist was big help in going threw what Medicare plan combination for my expensive drugs benefited me. He also said each year I needed to look at approved list of drugs in January as it is updated. then he asked If I had aaa and gave me 10% more off .long winded lots of paper work hope helpfull to others.
MrUbiquit... gold4k
23 Nov 2011
I just called Costco, and they said provigil was $30/PILL
LaurafromTx
11 Mar 2012
Do you have any insurance at all or none?
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I am on medicare, and it is covering Nuvigil, it must go through the process of being approved. First I took the Rx to the pharmacist, then they send it back to the physician, he then contacts Medicare for approval, then the physician sends the Rx and approval back to the pharmacist. Don't know why the doctor can't just do the pre-approval first, but he can't. Because there is no generic or comparable drug, the pharmacist told me they pretty much always approve it. I notice you posted it this last year, so maybe they approve it now and didn't before? I am on a new prescription, so it was approved for me just last month.